Acute diverticulitis in immunocompromised patients: evidence from an international multicenter observational registry (Web-based International Register of Emergency Surgery and Trauma, Wires-T)

Tartaglia, D.; Cremonini, C.; Annunziata, E.; Catena, F.; Sartelli, M.; Kirkpatrick, A. W.; Musetti, S.; Strambi, S.; Chiarugi, M.; Coccolini, F.; Salvetti, F.; Fugazzola, P.; Ceresoli, M.; Benedetti, F.; Elisa, N. G.; Litvin, A.; Lostoridis, E.; Ahmed, A. Y. Y. M.; Manatakis, D.; Negoi, I.; Ioannidis, O.; Uzunoglu, M. Y.; Tochie, J. N.; Cillara, N.; Tomadze, G.; Bala, M.; Isik, A.; Fonseca, V. C.; Bellanova, G.; Ghannam, W.; Yalkin, O.; Garcia, F. H.; Altintoprak, F.; Hadzhiev, D.; Chirica, M.; Zese, M.; Balalis, D.; Cui, Y.; Luppi, D.; Romeo, L.; Muratore, A.; Lunghi, E. G.; Yovtchev, Y.; Dimitrov, E.; Nikolopoulos, I.; Omerovic, M.; Zizzo, M.; Ugoletti, L.; Costa, G.; Scalzone, R.; Perrone, S.; Occhionorelli, S.; Nardi, M.; Gubbiotti, F.; Muhtaroglu, A.; Scaramuzzo, R.; Corte, H.; Yanez, C.; Zakaria, A. D.; Seretis, C.; Gelmini, R.; Pappalardo, V.; Paratore, F.; Sydorchuk, R.; Mulita, F.; Kara, Y.; Toma, E. A.; Vailas, M.; Sotiropoulou, M.; Elbahnasawy, M.; Sibilla, M. G.; Martines, G.; Goksoy, B.; Hadzhiev, D.; Parini, D.; Zaghi, C.; Podda, M.; Osipov, A.; Brisinda, G.; Gambino, G.; Doklestic, L. A. K.; Loncar, Z.; Micic, D.; Lesevic, I.; D'Agostino, F.; Garzali, I. U.; Caicedo, Y.; Marcela, L.; Marin, P. A. G.; Perivoliotis, K.; Ntentas, I.; Kuptsov, A.; Chowdhury, S.; Patel, T.

doi:10.1007/s10151-023-02758-6

Background: Immunocompromised patients with acute diverticulitis are at increased risk of morbidity and mortality. The aim of this study was to compare clinical presentations, types of treatment, and outcomes between immunocompromised and immunocompetent patients with acute diverticulitis. Methods: We compared the data of patients with acute diverticulitis extracted from the Web-based International Registry of Emergency Surgery and Trauma (WIRES-T) from January 2018 to December 2021. First, two groups were identified: medical therapy (A) and surgical therapy (B). Each group was divided into three subgroups: nonimmunocompromised (grade 0), mildly to moderately (grade 1), and severely immunocompromised (grade 2). Results: Data from 482 patients were analyzed—229 patients (47.5%) [M:F = 1:1; median age: 60 (24–95) years] in group A and 253 patients (52.5%) [M:F = 1:1; median age: 71 (26–94) years] in group B. There was a significant difference between the two groups in grade distribution: 69.9% versus 38.3% for grade 0, 26.6% versus 51% for grade 1, and 3.5% versus 10.7% for grade 2 (p < 0.00001). In group A, severe sepsis (p = 0.027) was more common in higher grades of immunodeficiency. Patients with grade 2 needed longer hospitalization (p = 0.005). In group B, a similar condition was found in terms of severe sepsis (p = 0.002), quick Sequential Organ Failure Assessment score > 2 (p = 0.0002), and Mannheim Peritonitis Index (p = 0.010). A Hartmann’s procedure is mainly performed in grades 1–2 (p < 0.0001). Major complications increased significantly after a Hartmann’s procedure (p = 0.047). Mortality was higher in the immunocompromised patients (p = 0.002). Conclusions: Immunocompromised patients with acute diverticulitis present with a more severe clinical picture. When surgery is required, immunocompromised patients mainly undergo a Hartmann’s procedure. Postoperative morbidity and mortality are, however, higher in immunocompromised patients, who also require a longer hospital stay.

Acute diverticulitis in immunocompromised patients: evidence from an international multicenter observational registry (Web-based International Register of Emergency Surgery and Trauma, Wires-T) / Tartaglia, D.; Cremonini, C.; Annunziata, E.; Catena, F.; Sartelli, M.; Kirkpatrick, A. W.; Musetti, S.; Strambi, S.; Chiarugi, M.; Coccolini, F.; Salvetti, F.; Fugazzola, P.; Ceresoli, M.; Benedetti, F.; Elisa, N. G.; Litvin, A.; Lostoridis, E.; Ahmed, A. Y. Y. M.; Manatakis, D.; Negoi, I.; Ioannidis, O.; Uzunoglu, M. Y.; Tochie, J. N.; Cillara, N.; Tomadze, G.; Bala, M.; Isik, A.; Fonseca, V. C.; Bellanova, G.; Ghannam, W.; Yalkin, O.; Garcia, F. H.; Altintoprak, F.; Hadzhiev, D.; Chirica, M.; Zese, M.; Balalis, D.; Cui, Y.; Luppi, D.; Romeo, L.; Muratore, A.; Lunghi, E. G.; Yovtchev, Y.; Dimitrov, E.; Nikolopoulos, I.; Omerovic, M.; Zizzo, M.; Ugoletti, L.; Costa, G.; Scalzone, R.; Perrone, S.; Occhionorelli, S.; Nardi, M.; Gubbiotti, F.; Muhtaroglu, A.; Scaramuzzo, R.; Corte, H.; Yanez, C.; Zakaria, A. D.; Seretis, C.; Gelmini, R.; Pappalardo, V.; Paratore, F.; Sydorchuk, R.; Mulita, F.; Kara, Y.; Toma, E. A.; Vailas, M.; Sotiropoulou, M.; Elbahnasawy, M.; Sibilla, M. G.; Martines, G.; Goksoy, B.; Hadzhiev, D.; Parini, D.; Zaghi, C.; Podda, M.; Osipov, A.; Brisinda, G.; Gambino, G.; Doklestic, L. A. K.; Loncar, Z.; Micic, D.; Lesevic, I.; D'Agostino, F.; Garzali, I. U.; Caicedo, Y.; Marcela, L.; Marin, P. A. G.; Perivoliotis, K.; Ntentas, I.; Kuptsov, A.; Chowdhury, S.; Patel, T.. - In: TECHNIQUES IN COLOPROCTOLOGY. - ISSN 1123-6337. - 27:9(2023), pp. 747-757. [10.1007/s10151-023-02758-6]

Acute diverticulitis in immunocompromised patients: evidence from an international multicenter observational registry (Web-based International Register of Emergency Surgery and Trauma, Wires-T)

Tartaglia D.;Cremonini C.;Annunziata E.;Catena F.;Sartelli M.;Kirkpatrick A. W.;Musetti S.;Strambi S.;Chiarugi M.;Coccolini F.;Salvetti F.;Fugazzola P.;Ceresoli M.;Benedetti F.;Elisa N. G.;Litvin A.;Lostoridis E.;Ahmed A. Y. Y. M.;Manatakis D.;Negoi I.;Ioannidis O.;Uzunoglu M. Y.;Tochie J. N.;Cillara N.;Tomadze G.;Bala M.;Isik A.;Fonseca V. C.;Bellanova G.;Ghannam W.;Yalkin O.;Garcia F. H.;Altintoprak F.;Hadzhiev D.;Chirica M.;Zese M.;Balalis D.;Cui Y.;Luppi D.;Romeo L.;Muratore A.;Lunghi E. G.;Yovtchev Y.;Dimitrov E.;Nikolopoulos I.;Omerovic M.;Zizzo M.;Ugoletti L.;Costa G.;Scalzone R.;Perrone S.;Occhionorelli S.;Nardi M.;Gubbiotti F.;Muhtaroglu A.;Scaramuzzo R.;Corte H.;Yanez C.;Zakaria A. D.;Seretis C.;Gelmini R.;Pappalardo V.;Paratore F.;Sydorchuk R.;Mulita F.;Kara Y.;Toma E. A.;Vailas M.;Sotiropoulou M.;Elbahnasawy M.;Sibilla M. G.;Martines G.;Goksoy B.;Hadzhiev D.;Parini D.;Zaghi C.;Podda M.;Osipov A.;Brisinda G.;Gambino G.;Doklestic L. A. K.;Loncar Z.;Micic D.;Lesevic I.;D'Agostino F.;Garzali I. U.;Caicedo Y.;Marcela L.;Marin P. A. G.;Perivoliotis K.;Ntentas I.;Kuptsov A.;Chowdhury S.;Patel T.

2023

Abstract

Background: Immunocompromised patients with acute diverticulitis are at increased risk of morbidity and mortality. The aim of this study was to compare clinical presentations, types of treatment, and outcomes between immunocompromised and immunocompetent patients with acute diverticulitis. Methods: We compared the data of patients with acute diverticulitis extracted from the Web-based International Registry of Emergency Surgery and Trauma (WIRES-T) from January 2018 to December 2021. First, two groups were identified: medical therapy (A) and surgical therapy (B). Each group was divided into three subgroups: nonimmunocompromised (grade 0), mildly to moderately (grade 1), and severely immunocompromised (grade 2). Results: Data from 482 patients were analyzed—229 patients (47.5%) [M:F = 1:1; median age: 60 (24–95) years] in group A and 253 patients (52.5%) [M:F = 1:1; median age: 71 (26–94) years] in group B. There was a significant difference between the two groups in grade distribution: 69.9% versus 38.3% for grade 0, 26.6% versus 51% for grade 1, and 3.5% versus 10.7% for grade 2 (p < 0.00001). In group A, severe sepsis (p = 0.027) was more common in higher grades of immunodeficiency. Patients with grade 2 needed longer hospitalization (p = 0.005). In group B, a similar condition was found in terms of severe sepsis (p = 0.002), quick Sequential Organ Failure Assessment score > 2 (p = 0.0002), and Mannheim Peritonitis Index (p = 0.010). A Hartmann’s procedure is mainly performed in grades 1–2 (p < 0.0001). Major complications increased significantly after a Hartmann’s procedure (p = 0.047). Mortality was higher in the immunocompromised patients (p = 0.002). Conclusions: Immunocompromised patients with acute diverticulitis present with a more severe clinical picture. When surgery is required, immunocompromised patients mainly undergo a Hartmann’s procedure. Postoperative morbidity and mortality are, however, higher in immunocompromised patients, who also require a longer hospital stay.

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	Anno di pubblicazione
	
			2023
		
	Rivista
	
			TECHNIQUES IN COLOPROCTOLOGY
		
	N° del Volume
	
			27
		
	Fascicolo
	
			9
		
	Pagina iniziale
	
			747
		
	Pagina finale
	
			757
		
	Codice DOI
	
			https://dx.doi.org/10.1007/s10151-023-02758-6
		
	Codice WoS
	
			WOS:000940450500001
		
	Codice Scopus
	
			2-s2.0-85147711396
		
	Codice PubMed
	
			36749438
		
	Citazione
	
			Acute diverticulitis in immunocompromised patients: evidence from an international multicenter observational registry (Web-based International Register of Emergency Surgery and Trauma, Wires-T) / Tartaglia, D.; Cremonini, C.; Annunziata, E.; Catena, F.; Sartelli, M.; Kirkpatrick, A. W.; Musetti, S.; Strambi, S.; Chiarugi, M.; Coccolini, F.; Salvetti, F.; Fugazzola, P.; Ceresoli, M.; Benedetti, F.; Elisa, N. G.; Litvin, A.; Lostoridis, E.; Ahmed, A. Y. Y. M.; Manatakis, D.; Negoi, I.; Ioannidis, O.; Uzunoglu, M. Y.; Tochie, J. N.; Cillara, N.; Tomadze, G.; Bala, M.; Isik, A.; Fonseca, V. C.; Bellanova, G.; Ghannam, W.; Yalkin, O.; Garcia, F. H.; Altintoprak, F.; Hadzhiev, D.; Chirica, M.; Zese, M.; Balalis, D.; Cui, Y.; Luppi, D.; Romeo, L.; Muratore, A.; Lunghi, E. G.; Yovtchev, Y.; Dimitrov, E.; Nikolopoulos, I.; Omerovic, M.; Zizzo, M.; Ugoletti, L.; Costa, G.; Scalzone, R.; Perrone, S.; Occhionorelli, S.; Nardi, M.; Gubbiotti, F.; Muhtaroglu, A.; Scaramuzzo, R.; Corte, H.; Yanez, C.; Zakaria, A. D.; Seretis, C.; Gelmini, R.; Pappalardo, V.; Paratore, F.; Sydorchuk, R.; Mulita, F.; Kara, Y.; Toma, E. A.; Vailas, M.; Sotiropoulou, M.; Elbahnasawy, M.; Sibilla, M. G.; Martines, G.; Goksoy, B.; Hadzhiev, D.; Parini, D.; Zaghi, C.; Podda, M.; Osipov, A.; Brisinda, G.; Gambino, G.; Doklestic, L. A. K.; Loncar, Z.; Micic, D.; Lesevic, I.; D'Agostino, F.; Garzali, I. U.; Caicedo, Y.; Marcela, L.; Marin, P. A. G.; Perivoliotis, K.; Ntentas, I.; Kuptsov, A.; Chowdhury, S.; Patel, T.. - In: TECHNIQUES IN COLOPROCTOLOGY. - ISSN 1123-6337. - 27:9(2023), pp. 747-757. [10.1007/s10151-023-02758-6]
		
	Tutti gli autori
	
			Tartaglia, D.; Cremonini, C.; Annunziata, E.; Catena, F.; Sartelli, M.; Kirkpatrick, A. W.; Musetti, S.; Strambi, S.; Chiarugi, M.; Coccolini, F.; Salvetti, F.; Fugazzola, P.; Ceresoli, M.; Benedetti, F.; Elisa, N. G.; Litvin, A.; Lostoridis, E.; Ahmed, A. Y. Y. M.; Manatakis, D.; Negoi, I.; Ioannidis, O.; Uzunoglu, M. Y.; Tochie, J. N.; Cillara, N.; Tomadze, G.; Bala, M.; Isik, A.; Fonseca, V. C.; Bellanova, G.; Ghannam, W.; Yalkin, O.; Garcia, F. H.; Altintoprak, F.; Hadzhiev, D.; Chirica, M.; Zese, M.; Balalis, D.; Cui, Y.; Luppi, D.; Romeo, L.; Muratore, A.; Lunghi, E. G.; Yovtchev, Y.; Dimitrov, E.; Nikolopoulos, I.; Omerovic, M.; Zizzo, M.; Ugoletti, L.; Costa, G.; Scalzone, R.; Perrone, S.; Occhionorelli, S.; Nardi, M.; Gubbiotti, F.; Muhtaroglu, A.; Scaramuzzo, R.; Corte, H.; Yanez, C.; Zakaria, A. D.; Seretis, C.; Gelmini, R.; Pappalardo, V.; Paratore, F.; Sydorchuk, R.; Mulita, F.; Kara, Y.; Toma, E. A.; Vailas, M.; Sotiropoulou, M.; Elbahnasawy, M.; Sibilla, M. G.; Martines, G.; Goksoy, B.; Hadzhiev, D.; Parini, D.; Zaghi, C.; Podda, M.; Osipov, A.; Brisinda, G.; Gambino, G.; Doklestic, L. A. K.; Loncar, Z.; Micic, D.; Lesevic, I.; D'Agostino, F.; Garzali, I. U.; Caicedo, Y.; Marcela, L.; Marin, P. A. G.; Perivoliotis, K.; Ntentas, I.; Kuptsov, A.; Chowdhury, S.; Patel, T.
		
	Tipologia
	
			Articolo su rivista

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